| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 116 HUNTINGTON AVENUE BOSTON, MA 02116 | BLUE CROSS OF CALIFORNIA | $174K | — | $174K | 3.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD 6TH FLOOR GLENDALE, CA 91203 | DELTA DENTAL OF CALIFORNIA | $20K | — | $20K | 4.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD SUITE 600 GLENDALE, CA 91203 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $16K | — | $16K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | TWO PIERCE PLACE ITASCA, IL 60143 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $534 | $534 | 0.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 505 NORTH BRAND BOULEVARD GLENDALE, CA 91203 | EYEMED VISION CARE | $4K | — | $4K | 9.16% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 391 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 399 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 869 | $5.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 768 | $419K |
| Vision | EYEMED VISION CARE | 871 | $39K |
| Life insurance | BLUE CROSS OF CALIFORNIA | 869 | $5.0M |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 391 | $107K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 391 | $107K |
| Prescription drug | BLUE CROSS OF CALIFORNIA | 869 | $5.0M |
| Other | BLUE CROSS OF CALIFORNIA | 869 | $5.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 871 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.